Familial and community environmental risk factors for Helicobacter pylori infection in children and adolescents

Background: The aim of the study was to identify familial and community env ironmental risk factors associated with Helicobacter pylori infection in a pediatric population. Methods: Children requiring diagnostic upper endoscopy were included in the study during a 2-year period. During endoscopy, five gastric biopsies were per-formed for the histologic or bacteriologic diagnosis, or both, of H. p ylori infection. Epidemiologic data collected by a questionnaire were analy zed using the chi-square test or Fisher test and stepwise logistic regressi on. Results: The authors included 436 patients (242 boys), aged 2 days to 17.9 years (median, 2.7 years). H. pylori prevalence was 7.3%. Univariate analys is found H. pylori was more common in older patients (P < 0.00001), in chil dren who had at least one parent born in a developing country (P < 0.02) or with a low socioeconomic status (P < 0.02), and in those living in crowded conditions (P < 0.02). Children whose mother worked at home were more freq uently infected than children whose mother worked outside the home (P < 0.0 2). Attendance at nursery or school before the age of 6 years was not assoc iated with infection. Logistic regression showed a strong association with H. pylori only for age and number of persons at home. Conclusions: The Source of H. pylori is intrafamilial rather than from a co mmunity, such as nursery and school attended at a young age. The number of persons in the home influences the infection status of children but not by the presence of the mother in home. These data suggest that H. pylori infec tion transmission occurs from siblings or the father rather than from mothe r.